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首页> 外文期刊>Diabetes care >Insulin resistance and truncal obesity as important determinants of the greater incidence of diabetes in Indian Asians and African Caribbeans compared with Europeans: The Southall and Brent Revisited (SABRE) cohort
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Insulin resistance and truncal obesity as important determinants of the greater incidence of diabetes in Indian Asians and African Caribbeans compared with Europeans: The Southall and Brent Revisited (SABRE) cohort

机译：胰岛素抵抗和腰椎肥胖是印度人亚洲人和非洲加勒比人与欧洲人相比糖尿病发病率更高的重要决定因素：索撒尔和布伦特再访（SABRE）队列

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OBJECTIVE-Todetermine the extent of, and reasons for,ethnicdifferences intype2diabetes incidence in the U.K. RESEARCH DESIGN AND METHODS-Population- based triethnic cohort. Participants were without diabetes, aged 40-69 at baseline (1989-1991), and followed-up for 20 years. Baseline measurements included fasting and postglucose bloods, anthropometry, and lifestyle questionnaire. Incident diabetes was identified from medical records and participant recall. Ethnic differences in diabetes incidence were examined using competing risks regression. RESULTS-Incident diabetes was identified in 196 of 1,354 (14%) Europeans, 282 of 839 (34%) Indian Asians, and 100 of 335 (30%) African Caribbeans. All Indian Asians and African Caribbeans were first-generation migrants. Compared with Europeans, age-adjusted subhazard ratios (SHRs [95% CI]) for men and women, respectively, were 2.88 (95%, 2.36-3.53; P < 0.001) and 1.91 (1.18-3.10; P = 0.008) in Indian Asians, and 2.23 (1.64-3.03; P < 0.001) and 2.51 (1.63-3.87; P < 0.001) in African Caribbeans. Differences in baseline insulin resistance and truncal obesity largely attenuated the ethnic minority excess in women (adjusted SHRs: Indian Asians 0.77 [0.49-1.42]; P = 0.3; African Caribbeans 1.48 [0.89-2.45]; P = 0.13), but not in men (adjusted SHRs: Indian Asians 1.98 [1.52-2.58]; P < 0.001 and African Caribbeans, 2.05 [1.46- 2.89; P < 0.001]). CONCLUSIONS-Insulin resistance and truncal obesity account for the twofold excess incidence of diabetes in Indian Asian and African Caribbean women, but not men. Explanations for the excess diabetes risk in ethnic minority men remains unclear. Further study requires more precise measures of conventional risk factors and identification of novel risk factors.
机译：目的-确定英国2型糖尿病的种族差异程度和原因-研究设计和方法-基于人口的三种族队列。参与者没有糖尿病，基线时为40-69岁（1989-1991年），并随访了20年。基线测量包括禁食和葡萄糖后血液，人体测量法和生活方式问卷。从医疗记录和参与者回忆中确定了突发性糖尿病。使用竞争风险回归分析了糖尿病发病率的种族差异。结果在1354名欧洲人中有196名（14％），在839名印度人中有282名（34％）和335名非洲人中有100名（30％）被确定为糖尿病。所有的印度亚洲人和非洲加勒比人都是第一代移民。与欧洲人相比，男性的年龄调整后亚危险比（SHR [95％CI]）分别为2.88（95％，2.36-3.53; P <0.001）和1.91（1.18-3.10; P = 0.008）。印度亚洲人和非洲加勒比地区的2.23（1.64-3.03; P <0.001）和2.51（1.63-3.87; P <0.001）。基线胰岛素抵抗和躯干肥胖的差异在很大程度上减轻了妇女的少数族裔过剩（调整后的SHR：印度亚洲人0.77 [0.49-1.42]; P = 0.3;非洲人加勒比1.48 [0.89-2.45]; P = 0.13），但在男性（调整后的SHR：印度亚洲人1.98 [1.52-2.58]; P <0.001，非洲加勒比海地区2.05 [1.46- 2.89; P <0.001]）。结论胰岛素抵抗和躯干肥胖是印度亚洲和非洲加勒比海妇女（而非男性）糖尿病发病率的两倍高。关于少数族裔男性患糖尿病风险过高的解释仍不清楚。进一步的研究要求对常规危险因素进行更精确的测量，并确定新的危险因素。

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